CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Fairview Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $19
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 2.25x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Fairview Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.25x the Medicare baseline. Located in 18101 Lorain Avenue, Cleveland, OH.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)
Cash / Self-Pay: $36 (426%)
Insurance Median: $19 (225%)
Cash: $36 (426% of Medicare)
Ins. Median: $19 (225% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 225% of the Medicare baseline (a markup of 125%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Cigna $7 - $44 83%
Aetna $8 - $55 95%
Devoted Health $8 95%
Humana $8 - $47 95%
Mmo $8 - $32 95%
Summacare $8 - $21 95%
The Health Plan $8 - $33 95%
United $8 - $18 95%
UnitedHealthcare $8 - $34 95%
Upmc $8 - $33 95%
Valor $8 95%
Cc Ehp $9 - $22 106%
Communicare $9 106%
Perennial Health $9 106%
Blue Cross Blue Shield $13 - $35 154%
Zing Health $16 189%
Oscar $17 - $21 201%
Paramount $17 201%
Buckeye $18 213%
Caresource $18 213%
Molina $18 213%
United Bh $18 213%
Amerihealth $19 225%
Aultcare $24 284%
Amish Community Aid Plan $25 - $28 296%
Ohcp $27 319%
Omas $28 331%
Healthsmart $30 355%
Ohio Healthy $30 355%
Php $33 390%
Phphi $33 390%
Gms $38 449%
Medical Benefit Corp $38 449%
Quality Care Partners $38 449%
Consociate Health $41 485%
Frontpath $50 591%
Managed Care Services $50 591%
Multiplan $50 591%
Tertiary Care Network $50 591%
Three Rivers $50 591%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18101 Lorain Avenue, Cleveland, OH 44111
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals